期刊
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
卷 45, 期 7, 页码 1741-1752出版社
WILEY
DOI: 10.1002/hed.27385
关键词
case volume; disparities; head and neck cancer; health disparities; safety-net hospital; socioeconomic status
The safety-net status of hospitals is associated with higher mortality index and cost in geriatric head and neck cancer patients. Medium case volume and safety-net status together predict higher mortality index.
BackgroundThe impact of safety-net status, case volume, and outcomes among geriatric head and neck cancer patients is unknown. MethodsChi-square tests and Student's t tests to compare head and neck surgery outcomes of elderly patients between safety-net and non-safety-net hospitals. Multivariable linear regressions to determine predictors of outcome variables including mortality index, ICU stays, 30-day readmission, total direct cost, and direct cost index. ResultsCompared with non-safety-net hospitals, safety-net hospitals had a higher average mortality index (1.04 vs. 0.32, p = 0.001), higher mortality rate (1% vs. 0.5%, p = 0.002), and higher direct cost index (p = 0.001). A multivariable model of mortality index found the interaction between safety-net status and medium case volume was predictive of higher mortality index (p = 0.006). ConclusionSafety-net status is correlated with higher mortality index and cost in geriatric head and neck cancer patients. The interaction between medium volume and safety-net status is independently predictive of higher mortality index.
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